HESI RN MED SURG EXIT 400 ACTUAL EXAM
PAPER 2026 QUESTIONS WITH ANSWERS
GRADED A+
◉ A 55-year-old male client has been admitted to the hospital with a
medical diagnosis of chronic obstructive pulmonary disease (COPD).
Which risk factor is the most significant in the development of this
client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years.
Answer: C
Rationale:Smoking, considered to be a modifiable risk factor, is the
most significant risk factor for the development of COPD. The exact
mechanism of genetic and hereditary implications for the
development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling
secondhand smoke) may increase the likelihood of COPD incidence
,among family members. Options B and D do not exceed the risks
associated with cigarette smoking in the development of COPD.
◉ In assessing a client diagnosed with primary aldosteronism, the
nurse expects the laboratory test results to indicate a decreased
serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose
Answer: C
Rationale:Clients with primary aldosteronism exhibit a profound
decline in serum levels of potassium; hypokalemia; hypertension is
the most prominent and universal sign. The serum sodium level is
normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone
(PTH). Option D is not affected by primary aldosteronism.
◉ The nurse is completing an admission interview for a client with
Parkinson disease. Which question will provide additional
,information about manifestations that the client is likely to
experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?"
Answer: C
Rationale:Clients with Parkinson disease frequently experience
difficulty in initiating, maintaining, and performing motor activities.
They may even experience being rooted to the spot and unable to
move. Parkinson disease does not typically cause option A, B, or D.
◉ Client census is often used to determine staffing needs. Which
method of obtaining census determination for a particular unit
provides the best formula for determining long-range staffing
patterns?
A.
Midnight census
B.
Oncoming shift census
, C.
Average daily census
D.
Hourly census
Answer: C
Rationale:An average daily census is determined by trend data and
takes into account seasonal and daily fluctuations, so it is the best
method for determining staffing needs. Options A and B provide
data at a certain point in time, and that data could change quickly. It
is unrealistic to expect to obtain an hourly census, and such data
would only provide information about a certain point in time.
◉ A male client has just undergone a laryngectomy and has a cuffed
tracheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required
Answer: B
PAPER 2026 QUESTIONS WITH ANSWERS
GRADED A+
◉ A 55-year-old male client has been admitted to the hospital with a
medical diagnosis of chronic obstructive pulmonary disease (COPD).
Which risk factor is the most significant in the development of this
client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years.
Answer: C
Rationale:Smoking, considered to be a modifiable risk factor, is the
most significant risk factor for the development of COPD. The exact
mechanism of genetic and hereditary implications for the
development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling
secondhand smoke) may increase the likelihood of COPD incidence
,among family members. Options B and D do not exceed the risks
associated with cigarette smoking in the development of COPD.
◉ In assessing a client diagnosed with primary aldosteronism, the
nurse expects the laboratory test results to indicate a decreased
serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose
Answer: C
Rationale:Clients with primary aldosteronism exhibit a profound
decline in serum levels of potassium; hypokalemia; hypertension is
the most prominent and universal sign. The serum sodium level is
normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone
(PTH). Option D is not affected by primary aldosteronism.
◉ The nurse is completing an admission interview for a client with
Parkinson disease. Which question will provide additional
,information about manifestations that the client is likely to
experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?"
Answer: C
Rationale:Clients with Parkinson disease frequently experience
difficulty in initiating, maintaining, and performing motor activities.
They may even experience being rooted to the spot and unable to
move. Parkinson disease does not typically cause option A, B, or D.
◉ Client census is often used to determine staffing needs. Which
method of obtaining census determination for a particular unit
provides the best formula for determining long-range staffing
patterns?
A.
Midnight census
B.
Oncoming shift census
, C.
Average daily census
D.
Hourly census
Answer: C
Rationale:An average daily census is determined by trend data and
takes into account seasonal and daily fluctuations, so it is the best
method for determining staffing needs. Options A and B provide
data at a certain point in time, and that data could change quickly. It
is unrealistic to expect to obtain an hourly census, and such data
would only provide information about a certain point in time.
◉ A male client has just undergone a laryngectomy and has a cuffed
tracheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required
Answer: B
